Risk factors for syphilis among married men who have sex with men in China.

OBJECTIVE

The present study aimed to estimate the prevalence of syphilis among men who have sex with men (MSM) currently married with women in cities of China and examine the related factors for syphilis among them.

METHODS

"Snowballing" sampling was used to recruit participants in 4 cities from April 2008 to August 2009. Information of participants was collected anonymously and remained confidential. Blood samples were collected from all eligible participants for HIV and syphilis tests.

RESULTS

A total of 858 men participated in the study, and their average age was 38.3 years (ranged from 21 to 75 years). Fifty-three percent did not have residence cards, 37% accepted junior high school education or less, and 41% identified themselves as gay. The prevalence of HIV and syphilis was 8.0% and 17.9%, respectively. Older age, less education, homosexual orientation, the sex of the first sexual partner, residential places, and HIV infection were significantly associated with syphilis infection. Gay had higher proportions of some risk sexual behaviors than did non-gay-identified participants, including the first insert sex before 18 years (17.9% vs. 13.0%), the first male sex partner (49.0% vs. 34.3%) anal sex in the last 6 months (88.0% vs. 83.0%), noncondom use in the last anal sex (35.9% vs. 28.0%), and never use condom in anal sex in the last 6 months (14.8% vs. 9.1%). Non-gay-identified participants had a higher proportion of having opposite sex than did gay participants (70.8% vs. 43.0%).

CONCLUSIONS

Currently married MSM had a high prevalence of syphilis, and preventive interventions should be developed to control syphilis transmissions among currently married MSM via extromarital sex and intromarital opposite sex.